Implantable medical device having two electrodes in the header

ABSTRACT

Various aspects of the present disclosure are directed toward apparatuses, systems, and methods for supporting components of an implantable medical device. The apparatuses, systems, and methods may include a first electrode and a second electrode and a scaffold assembly configured to support the first electrode and the second electrode.

CROSS-REFERENCE TO RELATED APPLICATION

This application claims priority to Provisional Application No.62/751,677, filed Oct. 28, 2018, which is herein incorporated byreference in its entirety.

TECHNICAL FIELD

Embodiments of the present disclosure relate to medical devices andsystems for sensing physiological parameters and/or delivering therapy.More specifically, embodiments of the disclosure relate to devices andmethods for header core fixation in an implantable medical device.

BACKGROUND

Implantable medical devices (IMDs) may be configured to sensephysiological parameters and/or provide therapy and may include one ormore electrodes for performing aspects of these functions. IMDs may alsoinclude antennas for communicating with other devices. Conventionally,devices such as programmers and wands have been used to cause IMDs totake various actions such as for example, marking recordings ofphysiological parameters, initiating communications with other devices,and the like.

SUMMARY

In Example 1, an apparatus for supporting components of an implantablemedical device includes a first electrode and a second electrode; and ascaffold assembly configured to support and separate the first electrodeand the second electrode relative to a longitudinal axis of the scaffoldassembly.

In Example 2, further to the apparatus of Example 1, the scaffoldassembly is configured to support the first electrode along a firstsurface of the scaffold assembly and the second electrode along a secondsurface of the scaffold assembly that opposes the first surface.

In Example 3, further to the apparatus of any one of Examples 1-2, thescaffold assembly is configured to arrange the first electrode parallelto the second electrode.

In Example 4, further to the apparatus of Example 3, the scaffoldassembly includes a frontward facing portion and a rearward facingportion, and the first electrode is arranged on the frontward facingportion and the second electrode is arranged on the rearward facingportion.

In Example 5, further to the apparatus of any one of Examples 1-3, theapparatus also includes the implantable medical device having a header,a core assembly including integrated circuitry configured to selectbetween the first electrode and the second electrode.

In Example 6, further to the apparatus of Example 5, the integratedcircuitry is configured to measure sensing capability of the firstelectrode and sensing capability of the second electrode and selectbetween the first electrode and the second electrode in response todetermining a greater of the sensing capability of the first electrodeand the sensing capability of the second electrode.

In Example 7, further to the apparatus of Example 6, the integratedcircuitry is configured to measure impedance on a sensed signal of thefirst electrode and an impedance on a sensed signal of the secondelectrode to determine the sensing capability of the first electrode andthe sensing capability of the second electrode.

In Example 8, further to the apparatus of any one of Examples 5-7, thefirst electrode and the second electrode are arranged at a proximal endof the core assembly and further comprising a third electrode arrangedat a distal end of the core assembly.

In Example 9, further to the apparatus of Example 8, the integratedcircuitry is configured to drive the third electrode and one of thefirst electrode and the second electrode and to sense another of thefirst electrode and the second electrode.

In Example 10, further to the apparatus of any one of Examples 5-9, thescaffold assembly is arranged within the header and the scaffoldassembly is configured to support and position the first electrode andwith a first surface of an interior portion of the header and positionthe second electrode and with a second surface of the interior portionof the header.

In Example 11, further to the apparatus of any one of Examples 5-10, theintegrated circuitry includes a Kelvin connection to the first electrodeand the second electrode.

In Example 12, further to the apparatus of any one of Examples 5-11, theapparatus also includes a first electrical connector configured toconnect the first electrode to the integrated circuitry within the coreassembly and a second electrical connector configured to connect thesecond electrode to the integrated circuitry within the core assembly.

In Example 13, further to the apparatus of any one of Examples 1-12, theapparatus also includes an antenna arranged on the scaffold and betweenthe first electrode and the second electrode.

In Example 14, further to the apparatus of Example 13, wherein theantenna is arranged along a top portion of the scaffold assembly.

In Example 15, further to the apparatus of any one of Examples 1-14, thefirst electrode includes a first area and the second electrode includesa second area, and the first area is substantially equal to the firstarea.

In Example 16, an apparatus for supporting components of an implantablemedical device includes a first electrode and a second electrode; and ascaffold assembly configured to interface with a portion of animplantable medical device and configured to support the first electrodealong a first surface of the scaffold assembly and the second electrodealong a second surface of the scaffold assembly that opposes the firstsurface.

In Example 17, further to the apparatus of Example 16, the scaffoldassembly is configured to arrange the first electrode parallel to thesecond electrode.

In Example 18, further to the apparatus of Example 17, the scaffoldassembly includes a frontward facing portion and a rearward facingportion, and the first electrode is arranged on the frontward facingportion and the second electrode is arranged on the rearward facingportion.

In Example 19, further to the apparatus of Example 16, the apparatusalso includes the implantable medical device having a header, a coreassembly including integrated circuitry configured to select between thefirst electrode and the second electrode.

In Example 20, further to the apparatus of Example 19, the integratedcircuitry is configured to measure sensing capability of the firstelectrode and sensing capability of the second electrode and selectbetween the first electrode and the second electrode in response todetermining a greater of the sensing capability of the first electrodeand the sensing capability of the second electrode.

In Example 21, further to the apparatus of Example 20, the integratedcircuitry is configured to measure impedance on a sensed signal of thefirst electrode and an impedance on a sensed signal of the secondelectrode to determine the sensing capability of the first electrode andthe sensing capability of the second electrode.

In Example 22, further to the apparatus of Example 19, the firstelectrode and the second electrode are arranged at a proximal end of thecore assembly and further comprising a third electrode arranged at adistal end of the core assembly.

In Example 23, further to the apparatus of Example 22, the integratedcircuitry is configured to drive the third electrode and one of thefirst electrode and the second electrode and to sense another of thefirst electrode and the second electrode.

In Example 24, further to the apparatus of Example 19, the scaffoldassembly is arranged within the header and the scaffold assembly isconfigured to support and position the first electrode and with a firstsurface of an interior portion of the header and position the secondelectrode and with a second surface of the interior portion of theheader.

In Example 25, further to the apparatus of Example 16, the apparatusalso includes an antenna arranged on the scaffold and between the firstelectrode and the second electrode.

In Example 26, further to the apparatus of Example 19, the firstelectrode includes a first area and the second electrode includes asecond area, and the first area is substantially equal to the firstarea.

In Example 27, an apparatus includes a medical device configured to beimplanted within a body of a patient including: a core assembly having aproximal end and a distal end, a header coupled to the proximal end ofthe core assembly, a first electrode and a second electrode arrangedwithin the header, a third electrode arranged at the distal end of thecore assembly, and a scaffold assembly arranged within the header andconfigured to support and separate the first electrode and the secondelectrode relative to a longitudinal axis of the scaffold assembly.

In Example 28, further to the apparatus of Example 27, the scaffoldassembly is configured to interface with a portion of the core assemblyand configured to support the first electrode along a first surface ofthe scaffold assembly and the second electrode along a second surface ofthe scaffold assembly that opposes the first surface.

In Example 29, further to the apparatus of Example 27, the apparatusalso includes integrated circuitry arranged within the core assembly andconfigured to measure sensing capability of the first electrode andsensing capability of the second electrode and select between the firstelectrode and the second electrode in response to determining a greaterof the sensing capability of the first electrode and the sensingcapability of the second electrode.

In Example 30, further to the apparatus of Example 29, the integratedcircuitry is configured to measure impedance on a sensed signal of thefirst electrode and an impedance on a sensed signal of the secondelectrode to determine the sensing capability of the first electrode andthe sensing capability of the second electrode.

In Example 31, further to the apparatus of Example 29, the integratedcircuitry is configured to drive the third electrode and one of thefirst electrode and the second electrode and to sense another of thefirst electrode and the second electrode.

In Example 32, further to the apparatus of Example 29, the scaffoldassembly is arranged within the header and the scaffold assembly isconfigured to support and position the first electrode and with a firstsurface of an interior portion of the header and position the secondelectrode and with a second surface of the interior portion of theheader.

In Example 33, a method includes interfacing a scaffold assembly with acore assembly of an implantable medical device; arranging a firstcircuit component and a second circuit component on portions of thescaffold assembly, the scaffold assembly being configured to positionand support the first circuit component relative to the second circuitcomponent; and arranging a header assembly over and around the scaffoldassembly and interfacing the header assembly with the core assembly.

In Example 34, further to the method of Example 33, the method alsoincludes electrically connecting the first circuit component and thesecond circuit component to an integrated circuit arranged within thecore assembly.

In Example 35, further to the method of Example 34, electricallyconnecting the first circuit component and the second circuit componentcomprises welding the first circuit component and the second circuit torespective electrical connectors coupled to the integrated circuit.

While multiple embodiments are disclosed, still other embodiments of thepresent disclosure will become apparent to those skilled in the art fromthe following detailed description, which shows and describesillustrative embodiments of the subject matter disclosed herein.Accordingly, the drawings and detailed description are to be regarded asillustrative in nature and not restrictive.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a schematic illustration of a system having an implantablemedical device (IMD) and a receiving device.

FIG. 2A is a front-facing view of a header and scaffold assembly.

FIG. 2B is a back-facing view of the header and scaffold assembly shownin FIG. 2A.

FIG. 3A is a front-facing view of a header, scaffold assembly, and coreassembly.

FIG. 3B is a back-facing view of the header and the scaffold assembly,and the core assembly shown in FIG. 3A.

FIG. 4A is a front-facing view of an IMD.

FIG. 4B is a back-facing view of the IMD shown in FIG. 4A.

While the subject matter disclosed herein is amenable to variousmodifications and alternative forms, specific embodiments have beenshown by way of example in the drawings and are described in detailbelow. The intention, however, is not to limit the disclosure to theparticular embodiments described. On the contrary, the disclosure isintended to cover all modifications, equivalents, and alternativesfalling within the scope of the subject matter disclosed herein asdefined by the appended claims.

Although the term “block” may be used herein to connote differentelements illustratively employed, the term should not be interpreted asimplying any requirement of, or particular order among or between,various steps disclosed herein unless and except when explicitlyreferring to the order of individual steps.

DETAILED DESCRIPTION

FIG. 1 is a schematic illustration of a system 100 including animplantable medical device (IMD) 102 implanted within a patient's body104 and configured to communicate with a receiving device 106. Inembodiments, the IMD 102 may be implanted subcutaneously within animplantation location or pocket in the patient's chest or abdomen andmay be configured to monitor (e.g., sense and/or record) physiologicalparameters associated with the patient's heart 108. In embodiments, theIMD 102 may be an implantable cardiac monitor (ICM) (e.g., animplantable diagnostic monitor (IDM), an implantable loop recorder(ILR), etc.) configured to record physiological parameters such as, forexample, one or more cardiac activation signals, heart sounds, bloodpressure measurements, oxygen saturations, and/or the like.

In certain instances, the IMD 102 may be configured to monitorphysiological parameters that may include one or more signals indicativeof a patient's physical activity level and/or metabolic level, such asan acceleration signal. In certain instances, the IMD 102 may beconfigured to monitor physiological parameters associated with one ormore other organs, systems, and/or the like. The IMD 102 may beconfigured to sense and/or record at regular intervals, continuously,and/or in response to a detected event. In certain instances, such adetected event may be detected by one or more sensors of the IMD 102,another IMD (not shown), an external device (e.g., the receiving device106), and/or the like. In addition, the IMD 102 may be configured todetect a variety of physiological signals that may be used in connectionwith various diagnostic, therapeutic, and/or monitoring implementations.For example, the IMD 102 may include sensors or circuitry for detectingrespiratory system signals, cardiac system signals, and/or signalsrelated to patient activity. In certain instances, the IMD 102 may beconfigured to sense intrathoracic impedance, from which variousrespiratory parameters may be derived, including, for example,respiratory tidal volume and minute ventilation. Sensors and associatedcircuitry may be incorporated in connection with the IMD 102 fordetecting one or more body movement or body posture and/or positionrelated signals. For example, accelerometers and/or GPS devices may beemployed to detect patient activity, patient location, body orientation,and/or torso position.

For purposes of illustration, and not of limitation, various embodimentsof devices that may be used to record physiological parameters inaccordance with the present disclosure are described herein in thecontext of IMDs that may be implanted under the skin in the chest regionof a patient.

As shown, the IMD 102 may include a housing 110 having two electrodes112 and 114 coupled thereto. According to certain instances, the IMD 102may include any number of electrodes (and/or other types of sensors suchas, e.g., thermometers, barometers, pressure sensors, optical sensors,motion sensors, and/or the like) in any number of various types ofconfigurations, and the housing 110 may include any number of differentshapes, sizes, and/or features. In certain instances, the IMD 102 may beconfigured to sense physiological parameters and record thephysiological parameters. For example, the IMD 102 may be configured toactivate (e.g., periodically, continuously, upon detection of an event,and/or the like), record a specified amount of data (e.g., physiologicalparameters) in a memory, and communicate that recorded data to areceiving device 106. In the case of an IDM, for example, the IMD 102may activate, record cardiac signals for a certain period of time,deactivate, and activate to communicate the recorded signals to thereceiving device 106.

In various instances, the receiving device 106 may be, for example, aprogrammer, controller, patient monitoring system, and/or the like.Although illustrated in FIG. 1 as an external device, the receivingdevice 106 may include an implantable device configured to communicatewith the IMD 102 that may, for example, be a control device, anothermonitoring device, a pacemaker, an implantable defibrillator, a cardiacresynchronization therapy (CRT) device, and/or the like, and may be animplantable medical device known in the art or later developed, forproviding therapy and/or diagnostic data about the patient and/or theIMD 102. In certain instances, the IMD 102 may be a pacemaker, animplantable cardioverter defibrillator (ICD) device, or a cardiacresynchronization therapy (CRT) device. In certain instances, the IMD102 may include both defibrillation and pacing/CRT capabilities (e.g., aCRT-D device).

The system 100 may be used to implement coordinated patient measuringand/or monitoring, diagnosis, and/or therapy in accordance withembodiments of the disclosure. The system 100 may include, for example,one or more patient-internal medical devices, such as an IMD 102, andone or more patient-external medical devices, such as receiving device106. The receiving device 106 may be configured to perform monitoring,and/or diagnosis and/or therapy functions external to the patient (i.e.,not invasively implanted within the patient's body). The receivingdevice 106 may be positioned on the patient, near the patient, or in anylocation external to the patient.

The IMD 102 and the receiving device 106 may communicate through awireless link. For example, the IMD 102 and the receiving device 106 maybe coupled through a short-range radio link, such as Bluetooth, IEEE802.11, and/or a proprietary wireless protocol. The communications linkmay facilitate uni-directional and/or bi-directional communicationbetween the IMD 102 and the receiving device 106. Data and/or controlsignals may be transmitted between the IMD 102 and the receiving device106 to coordinate the functions of the IMD 102 and/or the receivingdevice 106. Patient data may be downloaded from one or more of the IMD102 and the receiving device 106 periodically or on command. Thephysician and/or the patient may communicate with the IMD 102 and thereceiving device 106, for example, to acquire patient data or toinitiate, terminate, or modify recording and/or therapy.

The illustrative system 100 shown in FIG. 1 is not intended to suggestany limitation as to the scope of use or functionality of embodiments ofthe subject matter disclosed throughout this disclosure. Neither shouldthe illustrative system 100 be interpreted as having any dependency orrequirement related to any single component or combination of componentsillustrated in FIG. 1. For example, in embodiments, the illustrativesystem 100 may include additional components. Additionally, any one ormore of the components depicted in FIG. 1 can be, in embodiments,integrated with various ones of the other components depicted therein(and/or components not illustrated). Any number of other components orcombinations of components can be integrated with the illustrativesystem 100 depicted in FIG. 1, all of which are considered to be withinthe ambit of this disclosure.

FIG. 2A is a front-facing view of a header 200 and scaffold assembly202. The scaffold assembly 202 may be an apparatus for supportingcomponents of an implantable medical device (e.g., as shown in FIG. 1and FIGS. 4A-B). The scaffold assembly 202 may be configured to supportand separate a first electrode 204 and a second electrode 206 relativeto a longitudinal axis 208 of the scaffold assembly 202.

In certain instances, the scaffold assembly 202 is configured to supportthe first electrode 204 along a first surface 210 of the scaffoldassembly 202 and the second electrode 206 along a second surface 212 ofthe scaffold assembly 202 that opposes the first surface 210. The firstsurface 210 may be a frontward facing portion and the second surface 212may be a rearward facing portion of the scaffold assembly 202 as shownin FIG. 2A and FIG. 2B. In other instances, the first surface 210 andthe second surface 212 may be sides of the scaffold assembly 202. Thescaffold assembly may be configured to arrange the first electrode 202parallel to the second electrode 204.

FIG. 2B is a back-facing view of the header 200 and the scaffoldassembly 202 shown in FIG. 2A. The header 200 includes an exteriorsurface 200A that encloses an interior region 200B. The header 202 mayhouse various circuitry components within the interior region 200B suchas the first electrode 204 and the second electrode 206. The exteriorsurface 200A may contact a patient's bodily tissue when an IMD, thatincludes the header 200, is subcutaneously implanted in an implantationlocation or pocket in the patient's chest or abdomen. The interiorregion 200B of the header 200 may provide a space and house the scaffoldassembly 202 and circuit components positioned and supported by thescaffold assembly 202. In order to enable sensing of physiologicalparameters within the patient, the first electrode 204 and the secondelectrode 206 may be positioned to be flush with the interior region200B of the header 200. In other instances, the first electrode 204 andthe second electrode 206 may be positioned by the scaffold assembly 202to form a portion of the exterior surface 200A of the header 202.

FIG. 3A is a front-facing view of a header 300, scaffold assembly 302,and core assembly 314 and FIG. 3B is a back-facing view of the header200 and the scaffold assembly 302, and the core assembly 314 shown inFIG. 3A. The scaffold assembly 302 includes a first surface 310 and asecond surface 312. FIG. 3A also shows a portion of a core assembly 314.The header 300, scaffold assembly 302, and core assembly 314 may formportions of an IMD (e.g., as shown in FIG. 1 and FIGS. 4A-B). Thescaffold assembly 304 may form a part of an apparatus for supportingcomponents of the IMD. As such, an end portion and a portion of anintermediate section of the core assembly 314 is shown in FIG. 3A.Further, additional elements of the IMD may be included at the other endportion of the core assembly 314 (not shown). These elements may includea battery and an electrode.

The scaffold assembly 302 may be configured to support and position oneor more circuit components. The scaffold assembly 302, for example, maybe configured to interface with a portion of the IMD and configured tosupport the first electrode 304 along the first surface 310 of thescaffold assembly 302 and a second electrode 306 along the secondsurface 312 of the scaffold assembly 302. In certain instances, thesecond surface 312 of the scaffold assembly 302 opposes the firstsurface 310. In addition, the scaffold assembly 302 may be configured toarrange the first electrode 304 parallel to the second electrode 306.

In certain instances, the core assembly 314 includes integratedcircuitry 316. The core assembly 314 may include one or more conduitsthat provide a feedthrough for at least one electrical connector orinterconnect. As shown in FIG. 3B, interconnects 318, 320, 322 areprovided and feed through the conduits to connect the first electrode304 and the second electrode 306 to the integrated circuitry 316. Incertain instances, the scaffold assembly 302 may also support an antenna324. In these instances, one of the interconnects 318, 320, 322 mayconnect the antenna 324 to the integrated circuitry 316.

The functionality of the first electrode 304 and the second electrode306 may be controlled by the integrated circuitry 316. For example, theintegrated circuitry 316 may be configured to select between the firstelectrode 304 and the second electrode 306. In addition, the integratedcircuitry 316 may be configured to measure sensing capability of thefirst electrode 304 and sensing capability of the second electrode 306.In certain instances, the integrated circuitry 316 may be configured toselect between the first electrode 304 and the second electrode 306 inresponse to determining which of the first electrode 304 and the secondelectrode 306 has a greater of the sensing capability. The integratedcircuitry 316 may be configured to measure impedance on a sensed signalof the first electrode 304 and an impedance on a sensed signal of thesecond electrode 306 to determine the sensing capability of the firstelectrode 304 and the sensing capability of the second electrode 306.

The scaffold assembly 302 supporting and arranging the first electrode304 and the second electrode 306 may reduce sensing noise when impedanceis measured (as compared to a device having a single electrode in aheader). In addition, the integrated circuitry 316 being configured toselect between the first electrode 304 and the second electrode 306 mayincreasing sensing capabilities and signal capture as compared to adevice having a single electrode within a header. As noted above Thescaffold assembly 304 may form a part of an apparatus for supportingcomponents of an IMD. When implanted, the IMD may turn or flip which mayaffect sensing capability of the IMD. The integrated circuitry 316 beingconfigured to select between the first electrode 304 and the secondelectrode 306 allows for selecting of whichever of the first electrode304 and the second electrode 306 has the stronger signal for sensing.

During the impedance measurement, the integrated circuitry 316 may beconfigured to drive a signal to one of the first electrode 304 and thesecond electrode 306 while sensing on the other of the first electrode304 and the second electrode 306. In these instances, the integratedcircuitry 316 may drive the signals to the first electrode 304 and thesecond electrode 306 in a loop to isolate the sensed signals.

In certain instances, functionality of the circuitry componentssupported and arranged by the scaffold assembly 302 may depend on thearrangement or positioning of the circuitry components. Morespecifically, unintended or uncontrolled movement of one or morecircuitry components, such as the first electrode 304 and the secondelectrode 306, may disconnect from integrated circuitry 316. Inaddition, the scaffold assembly 302 facilitates arranging the firstelectrode 304 and the second electrode 306 to ensure that the firstelectrode 304 and the second electrode 306 are arranged on oppositesides of the IMD to facilitate sensing.

In addition, the functionality of antenna 324 may also controlled byintegrated circuitry 316 housed within the core assembly 314. Thescaffold assembly 302 may center the antenna 324 between the firstelectrode 304 and the second electrode 306. In this manner, the scaffoldassembly 302 may facilitate performance of the antenna 324 and avoid RFinterference by keeping the antenna 324 from muscle tissue and closer tothe skin side (e.g., exterior side of a patient's body) of the header300 so there is less body tissue to transmit through.

The illustrative components shown in FIG. 3A and FIG. 3B are notintended to suggest any limitation as to the scope of use orfunctionality of embodiments of the disclosed subject matter. Neithershould the illustrative components be interpreted as having anydependency or requirement related to any single component or combinationof components illustrated therein. Additionally, any one or more of thecomponents depicted in FIG. 4A and FIG. 4B (discussed in further detailbelow) may be, in embodiments, integrated with various other componentsdepicted therein (and/or components not illustrated), all of which areconsidered to be within the ambit of the disclosed subject matter.

FIG. 4A is a front-facing view of an IMD 400 and FIG. 4B is aback-facing view of the IMD. The IMD may be, or may be similar to, theIMD 102 depicted in FIG. 1. The scaffold assembly 402 includes a firstsurface 410 and a second surface 412. The scaffold assembly 404 may forma part of an apparatus for supporting components of the IMD. The IMDalso includes a core assembly 414, which may house integrated circuitry(not shown) internal to the core assembly 414. The core assembly 414also includes a battery 426 and a third electrode 428.

The scaffold assembly 402 may be configured to support and position oneor more circuit components. The scaffold assembly 402 is configured tointerface with a portion of the core assembly 414 (e.g., as shown inFIGS. 3A-B). The scaffold assembly 402 may be configured to support andseparate a first electrode 404 and a second electrode 406 relative to alongitudinal axis of the scaffold assembly 402. The scaffold assembly402 may be configured to support the first electrode 404 along the firstsurface 410 of the scaffold assembly 402 and a second electrode 406along the second surface 412 of the scaffold assembly 402. In certaininstances, the second surface 412 of the scaffold assembly 402 opposesthe first surface 410. In addition, the scaffold assembly 402 may beconfigured to arrange the first electrode 404 parallel to the secondelectrode 406. In addition, the first electrode 404 may include a firstarea and the second electrode 406 includes a second area that issubstantially equal to the first area.

The functionality of the first electrode 404, the second electrode 406,and the third electrode 428 may be controlled by the integratedcircuitry. In certain instances, the integrated circuitry may beconfigured to select between the first electrode 404 and the secondelectrode 406. In addition, the integrated circuitry may be configuredto measure sensing capability of the first electrode 404 and sensingcapability of the second electrode 406. In certain instances, theintegrated circuitry may be configured to select between the firstelectrode 404 and the second electrode 406 in response to determiningwhich of the first electrode 404 and the second electrode 406 has agreater of the sensing capability.

The integrated circuitry may be configured to measure impedance on asensed signal of the first electrode 404 and an impedance on a sensedsignal of the second electrode 406 to determine the sensing capabilityof the first electrode 404 and the sensing capability of the secondelectrode 406. In certain instances, the integrated circuitry isconfigured to drive the third electrode 428 and one of the firstelectrode 404 and the second electrode 406 and to sense another of thefirst electrode 404 and the second electrode 406. In addition, theintegrated circuitry includes a Kelvin connection to the first electrode404 and the second electrode 406.

In certain instances, the core assembly 414 may include an accelerometerto determine whether or not the IMD has turned or flipped. Theaccelerometer may determine periods of electrode inactivity to determinea stable signal and select between the first electrode 404 and thesecond electrode 406.

The scaffold assembly 402 supporting and arranging the first electrode404 and the second electrode 406 may reduce sensing noise when impedanceis measured (as compared to a device having a single electrode in aheader). In addition, the integrated circuitry being configured toselect between the first electrode 404 and the second electrode 406 mayincreasing sensing capabilities and signal capture as compared to adevice having a single electrode within a header. As noted above, thescaffold assembly 404 may form a part of an apparatus for supportingcomponents of an IMD. When implanted, the IMD may turn or flip which mayaffect sensing capability of the IMD. The integrated circuitry beingconfigured to select between the first electrode 404 and the secondelectrode 406 allows for selecting of whichever of the first electrode404 and the second electrode 406 has the stronger signal for sensing.

In certain instances, the scaffold assembly 402 may also support anantenna 424. In addition, interconnects may connect the antenna 424 tothe integrated circuitry. The antenna 424 may be arranged along a topsurface of the scaffold assembly 402. In addition, the functionality ofantenna 424 may also controlled by integrated circuitry housed withinthe core assembly 414. The scaffold assembly 302 may center the antenna424 between the first electrode 404 and the second electrode 406. Inthis manner, the scaffold assembly 402 may facilitate performance of theantenna 424 and avoid RF interference by keeping the antenna 324 frommuscle tissue and closer to the skin side (e.g., exterior side of apatient's body) of the header 400 so there is less body tissue totransmit through.

Various modifications and additions can be made to the exemplaryembodiments discussed without departing from the scope of the presentdisclosure. For example, while the embodiments described above refer toparticular features, the scope of this disclosure also includesembodiments having different combinations of features and embodimentsthat do not include all of the described features. Accordingly, thescope of the present disclosure is intended to embrace all suchalternatives, modifications, and variations as fall within the scope ofthe claims, together with all equivalents thereof.

We claim:
 1. An apparatus for supporting components of an implantablemedical device, the apparatus comprising: a first electrode and a secondelectrode; and a scaffold assembly configured to interface with aportion of an implantable medical device and configured to support thefirst electrode along a first surface of the scaffold assembly and thesecond electrode along a second surface of the scaffold assembly thatopposes the first surface.
 2. The apparatus of claim 1, wherein thescaffold assembly is configured to arrange the first electrode parallelto the second electrode.
 3. The apparatus of claim 2, wherein thescaffold assembly includes a frontward facing portion and a rearwardfacing portion, and the first electrode is arranged on the frontwardfacing portion and the second electrode is arranged on the rearwardfacing portion.
 4. The apparatus of claim 1, further comprising theimplantable medical device having a header, a core assembly includingintegrated circuitry configured to select between the first electrodeand the second electrode.
 5. The apparatus of claim 4, wherein theintegrated circuitry is configured to measure sensing capability of thefirst electrode and sensing capability of the second electrode andselect between the first electrode and the second electrode in responseto determining a greater of the sensing capability of the firstelectrode and the sensing capability of the second electrode.
 6. Theapparatus of claim 5, wherein the integrated circuitry is configured tomeasure impedance on a sensed signal of the first electrode and animpedance on a sensed signal of the second electrode to determine thesensing capability of the first electrode and the sensing capability ofthe second electrode.
 7. The apparatus of claim 4, wherein the firstelectrode and the second electrode are arranged at a proximal end of thecore assembly and further comprising a third electrode arranged at adistal end of the core assembly.
 8. The apparatus of claim 7, whereinthe integrated circuitry is configured to drive the third electrode andone of the first electrode and the second electrode and to sense anotherof the first electrode and the second electrode.
 9. The apparatus ofclaim 4, wherein the scaffold assembly is arranged within the header andthe scaffold assembly is configured to support and position the firstelectrode and with a first surface of an interior portion of the headerand position the second electrode and with a second surface of theinterior portion of the header.
 10. The apparatus of claim 1, furthercomprising an antenna arranged on the scaffold and between the firstelectrode and the second electrode.
 11. The apparatus of claim 4,wherein the first electrode includes a first area and the secondelectrode includes a second area, and the first area is substantiallyequal to the first area.
 12. An apparatus comprising: a medical deviceconfigured to be implanted within a body of a patient comprising: a coreassembly having a proximal end and a distal end, a header coupled to theproximal end of the core assembly, a first electrode and a secondelectrode arranged within the header, a third electrode arranged at thedistal end of the core assembly, and a scaffold assembly arranged withinthe header and configured to support and separate the first electrodeand the second electrode relative to a longitudinal axis of the scaffoldassembly.
 13. The apparatus of claim 12, wherein the scaffold assemblyis configured to interface with a portion of the core assembly andconfigured to support the first electrode along a first surface of thescaffold assembly and the second electrode along a second surface of thescaffold assembly that opposes the first surface.
 14. The apparatus ofclaim 12, further comprising integrated circuitry arranged within thecore assembly and configured to measure sensing capability of the firstelectrode and sensing capability of the second electrode and selectbetween the first electrode and the second electrode in response todetermining a greater of the sensing capability of the first electrodeand the sensing capability of the second electrode.
 15. The apparatus ofclaim 14, wherein the integrated circuitry is configured to measureimpedance on a sensed signal of the first electrode and an impedance ona sensed signal of the second electrode to determine the sensingcapability of the first electrode and the sensing capability of thesecond electrode.
 16. The apparatus of claim 14, wherein the integratedcircuitry is configured to drive the third electrode and one of thefirst electrode and the second electrode and to sense another of thefirst electrode and the second electrode.
 17. The apparatus of claim 14,wherein the scaffold assembly is arranged within the header and thescaffold assembly is configured to support and position the firstelectrode and with a first surface of an interior portion of the headerand position the second electrode and with a second surface of theinterior portion of the header.
 18. A method comprising: interfacing ascaffold assembly with a core assembly of an implantable medical device;arranging a first circuit component and a second circuit component onportions of the scaffold assembly, the scaffold assembly beingconfigured to position and support the first circuit component relativeto the second circuit component; and arranging a header assembly overand around the scaffold assembly and interfacing the header assemblywith the core assembly.
 19. The method of claim 18, further comprisingelectrically connecting the first circuit component and the secondcircuit component to an integrated circuit arranged within the coreassembly.
 20. The method of claim 19, wherein electrically connectingthe first circuit component and the second circuit component compriseswelding the first circuit component and the second circuit to respectiveelectrical connectors coupled to the integrated circuit.